go back

Michigan rates for HCPCS L5658

Addition to lower extremity, socket insert, above knee (AK) (Kemblo, Pelite, Aliplast, Plastazote or equal)

Facilitymedian $589 · 10th–90th $309–$2,1880%10%20%10th90th$589Professionalmedian $275 · 10th–90th $191–$5500%20%10th90th$275$0.5$2.0$10.0$50.0$200.0$1.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $309.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $269.15 / $380.19
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $1,659.59 / $3,162.28
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $575.44
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $363.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $363.08 / $537.03
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $1,047.13 / $1,174.90
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $436.52 / $676.08
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $363.08
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $363.08 / $489.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $446.68 / $588.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $257.04 / $363.08